| NPI | 1508046376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A113241) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX bp10025759) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2021-05-26 |